Highlights
- •Families living in rural Nebraska experienced decreased health care access.
- •Geographic and social isolation cause dramatic lifestyle changes after a child's T1D diagnosis.
- •Technology improved diabetes management and access to care.
- •Interprofessional teams may provide novel health care delivery systems to increase access and decrease health care disparities.
Abstract
Introduction
This study aimed to explore the unique health care needs of rural Nebraska families
with a child with type 1 diabetes mellitus (T1DM).
Method
Using a phenomenological approach, the researchers conducted four focus groups across
Nebraska. The focus groups gathered input from children, caregivers, and health care
providers (n = 23). The researchers coded data and generated themes. Member checking, researcher
triangulation, reflexivity, a thick description of the process, and an audit trail
established trustworthiness.
Results
Four themes emerged: dramatic family and lifestyle changes following diagnosis, lack
of access to specialized care resulting in complications, isolation improved health
management resourcefulness, and technology improved health management and flexibility.
Discussion
Lifestyle changes persist after a child's diagnosis with T1DM. Rural families reported
unpredictable health status of their child, reduced health care services, and limited
information access. Conversely, limited specialty health care access, resources, and
community support led to creative self-education, advocacy, and health care management
strategies. Diabetes technology offered opportunities for improved provider-patient
communication and continuous glucose monitoring.
KEY WORDS
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Article info
Publication history
Published online: September 02, 2022
Footnotes
This work was supported by the Patient-centered Outcomes Research Institute (grant no. 10443), Creighton University's Center for Undergraduate Research and Scholarship, and the School of Pharmacy and Health Professions Fellowship.
Conflicts of interest: None to report.
Identification
Copyright
Copyright © 2022 by the National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
